Abstract
From 1975 to 1988, 144 patients naive of treatment, with non-metastatic soft tissue sarcoma were treated at Fondation Bergonié by surgery, followed by radiotherapy and without chemotherapy. An analysis of prognostic variables was done on this population to determine patients for whom an adjuvant chemotherapy would be relevant. Prognostic variables in overall survival (OS), metastasis-free survival (MFS), disease-free and local free recurrence survivals were analysed by univariate and multivariate analysis. In multivariate analysis using Cox's model, only tumour depth and tumour grade were significant with the MFS end point, while tumour depth, tumour grade and tumour site were significant when considering OS. A predictive stratification for patients is proposed: a favourable prognostic group with grade 1 tumour or superficial, grade 2 tumour (5-year OS: 97.8%; 5-year MFS: 100%); an intermediate prognostic group with deep, grade 2 tumour or superficial, grade 3 tumour (5-year OS: 58.8%; 5-year MFS: 48.1%); and finally a poor prognostic group with deep, grade 3 tumour (5-year OS: 31.7%; 5-year MFS: 34.1%). Patients in the intermediate and poor prognostic groups who present a high metastatic risk are to be considered for adjuvant chemotherapy trials.
Highlights
From 1975 to 1988, 381 patients were referred to Fondation Bergonie (FB) for Soft tissue sarcomas (STS) proven by a systematic histological review
The remaining 141 patients were considered for this study because they were those for whom an adjuvant chemotherapy could prove effective, as they were: (1) naive of treatment, (2) primarily treated by surgery, (3) treated and followed at a single institution, (4) without adjuvant or neoadjuvant chemotherapy
With a median follow-up of 57.6 months, 11 patients (7.8%) died from a cause unrelated to the treated sarcoma: cardiac or vascular disease: four; cerebral palsy: one, pulmonary infection: one; diabetes mellitus: one; suicide: one; other cancer: three; three of these patients presented a local recurrence and one a metastatic spread. These patients were excluded from the overall survival analysis but not from disease-free or metastasis-free survival evaluations
Summary
From 1975 to 1988, 381 patients were referred to Fondation Bergonie (FB) for STS proven by a systematic histological review. Fortyone presented with overt metastatic disease, 123 had a local recurrence after a previous treatment outside FB. The remaining 217 patients were referred for a non-metastatic and until untreated primary. In 32 patients, a preoperative chemotherapy was performed. 44 patients received adjuvant chemotherapy after resection of their primary; these patients were excluded. The remaining 141 patients were considered for this study because they were those for whom an adjuvant chemotherapy could prove effective, as they were: (1) naive of treatment, (2) primarily treated by surgery, (3) treated and followed at a single institution, (4) without adjuvant or neoadjuvant chemotherapy
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